Laparoscopic repair of recurrent Type 4 hiatal hernia after Roux-en-Y gastric bypass.

Mohammad Alsulaimy, MD, Ali Aminian, MD, FACS, Philip Schauer, MD, FACS. Cleveland Clinic Foundation

69 year old female with history of laparoscopic Roux-en-Y gastric bypass and hiatal hernia repair in 2012 who presented to outpatient clinic with epigastric abdominal pain and reflux symptoms for 3 weeks prior to presentation. CT-scan of the abdomen/pelvis revealed the entire Roux limb and gastric pouch herniating into the mediastinum. Laparoscopic repair was performed as shown in the video, with reinforcement with synthetic bioabsorbable mesh. 

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